metiamide and Pulmonary-Edema

Acid pneumonitis was produced in 18 dogs by the tracheal instillation of 3 ml/kg 0.1 N hydrochloric acid. Arterial and mixed venous oxygen tension, static compliance and pulmonary capillary wedge pressure were measured during a 2-hour observation period. Plasma histamine (measured by the enzymatic isotopic assay) increased from 1.7 +/- 0.2 ng/ml (mean +/- SE) before acid injury to 13.5 +/- 1.9 ng/ml after injury (p less than 0.05). In one group of 7 control dogs, 3 ml/kg of normal saline produced no increase in plasma histamine. Pulmonary edema secretions from acid injured animals had a histamine level of 30.3 +/- 3.8 ng/ml and slow reacting substance was detected in 7 of 11 animals. The slow reacting substance was an antihistamine-resistant, ethanol extractable substance that contracted guinea pig ileum. Lung weight-body weight ratio PaO2, and static compliance were different with acid pneumonitis compared to controls. Total protein was not different in the tracheal secretions compared to plasma. We conclude that histamine and slow reacting substance are released in this animal model of acid pneumonitis and may be important in the pathogenesis of the lung injury.

Topics: Animals; Autacoids; Capillary Permeability; Dogs; Histamine; Histamine Release; Hydrochloric Acid; Metiamide; Pneumonia; Pulmonary Edema

To see whether antihistamines could prevent and reverse histamine-induced pulmonary edema and increased lung vascular permeability, we compared the effects of a 4-h intravenous infusion of 4 mug/kg per min histamine phosphate on pulmonary hemodynamics, lung lymph flow, lymph and plasma protein content, arterial blood gases, hematocrit, and lung water with the effects of an identical histamine infusion given during an infusion of diphenhydramine or metiamide on the same variables in unanesthetized sheep. Histamine caused lymph flow to increase from 6.0+/-0.5 to 27.0+/-5.5 (SEM) ml/h (P less than 0.05), lymph; plasma globulin concentration ratio to increase from 0.62+/-0.01 to 0.67+/-0.02 (P less than 0.05), left atrial pressure to fall from 1+/-1 to -3+/-1 cm H2O (P less than 0.05), and lung lymph clearance of eight protein fractions ranging from 36 to 96 A molecular radius to increase significantly. Histamine also caused increases in lung water, pulmonary vascular resistance, arterial PCO2, pH, and hematocrit, and decreases in cardiac output and arterial PO2. Diphenhydramine (3 mg/kg before histamine followed by 1.5 mg/kg per h intravenous infusion) completely prevented the histamine effect on hematocrit, lung lymph flow, lymph protein clearance, and lung water content, and reduced histamine effects on arterial blood gases and pH. 6 mg/kg diphenhydramine given at the peak histamine response caused lymph flow and lymph: plasma protein concentration ratios to fall. Metiamide (10 mg/kg per h) did not affect the histamine lymph response. We conclude that diphenhydramine can prevent histamine-induced pulmonary edema and can prevent and reverse increased lung vascular permeability caused by histamine, and that histamine effects on lung vascular permeability are H1 actions.

Topics: Animals; Diphenhydramine; Histamine; Metiamide; Pulmonary Diffusing Capacity; Pulmonary Edema; Sheep